Njsda Form 1103 PDF Details

The Njsda 1103 form, vital for contractors involved in New Jersey Schools Development Authority (NJSDA) projects, serves a specific purpose in ensuring accurate payroll reporting under the Owner Controlled Insurance Program (OCIP). Detailed to encompass a variety of essential information, this form collects data on contractor addresses, payroll specifics, worker compensation classifications, general liability information, and total monthly receipts without encompassing burdens such as fringes or overtime premiums. Furthermore, it is designed to capture the raw wages of workers including pay for holidays, sick leave, and vacation but mandates the exclusion of extra wages for overtime hours which are to be reported at straight hourly rates. Interestingly, this comprehensive form, which needs to be submitted monthly, plays a crucial role in the administration and regulation of payroll compliance and insurance verification on NJSDA projects. By mandating the submission of unburdened payroll and hours worked, it ensures transparency and accuracy in the financial administration of construction projects. Additionally, strict adherence to submission timelines, which require contractors to forward completed forms to the designated address by the tenth business day of the following month, underscores the importance of this document in maintaining orderly project management and fiscal responsibility. The form not only simplifies the reporting process for contractors by requiring site-specific information pre-filled by the NJSDA but also safeguards against misclassification, thereby directly influencing a company's experience modifier with the New Jersey Compensation Rating & Inspection Bureau.

QuestionAnswer
Form NameNjsda Form 1103
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesKovach, Lakeview, 10th, Mandy

Form Preview Example

New Jersey Schools Development Authority - OCIP

OCIP Project Site Payroll Reporting Form 1103

Contractor

 

Street Address:

 

 

 

 

City:

 

 

 

 

 

State:

 

Zip:

 

 

Phone:

 

 

 

 

 

 

 

Fax:

 

 

 

 

 

 

 

 

 

Awarding Contractor:

 

 

 

 

 

 

Prime

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contractor:

 

 

 

 

 

 

 

Prepared By:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION CODE

First Report:

Last Report:

Payroll Month / Ending :_________________

 

(For this Contract):__________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORKERS’ COMPENSATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WC Classification

NJ WC Code

Actual Payroll

 

Man-hours

 

 

 

 

# of Workers Onsite

1.

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Payrolls & Man-hours

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GENERAL LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GL Classification Description

GL Code

 

 

Man-Hours

 

 

Payroll / Receipts / Other

1.

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

4.

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

5.

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Monthly receipts

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

•DO NOT SEND CERTIFIED PAYROLL. Payroll should be raw wages without burden, fringes, or overtime premium, but should include sick, vacation, holiday pay and imputed income.

•Earnings for overtime should be included only at straight hourly rates. DO NOT include the extra wages paid for overtime hours.

•Overtime means those hours in excess of 8 hours worked each day, 40 hours in any week or on Saturdays, Sundays or holidays, but only when there is an increase in the hourly rate to work such hours. Hours should be shown on overtime but pay should be for a straight wage.

•Total monthly receipts are required (amount on pay application for this work).

The above is a true and complete statement of the entire remuneration of services by employees of the company shown above.

Signature:

 

Title:

Date:

Send this form to:

CR Solutions

Phone: 678-339-9766

 

 

 

 

2400 Lakeview Parkway, Ste. 275

Fax: 866-339-5690

 

 

Alpharetta, GA. 30004

Attn: Mandy Kovach

NJSDA Form 1103

Revised 12/2009

OCIP Monthly Payroll Reporting Form (1103)

Instructions

-To be completed monthly for all work on a project site.

-A pre-filled form is mailed to each contractor and subcontractor with the enrollment packet (Certificate of Insurance and SDA OCIP Manual). Only the pre-filled form will be accepted. This is a site-specific form for each contractor with the location code and information that was provided on the enrollment form (WC/GL Classifications and codes).

-Payroll and hours should be totally unburdened and represent raw wages only

-Do not include overtime, fringes or other burdens

-Overtime means those hours in excess of 8 hours worked each day, 40 hours in any week or on Saturdays, Sundays or holidays, but only when there is an increase in the hourly rate

-Earnings for overtime should be included only as straight hourly rates. DO NOT include the extra wages paid for overtime hours.

-Total Monthly Receipts amounts are required – this is the amount on your pay applications for the time period worked

-By contract, it is the responsibility of the General Contractor to ensure that these payroll forms

are submitted each month. The GC shall collect the form from all their subcontractors and forward it to the OCIP Administration NO LATER than the tenth (10th) business day of the following month.

-DO NOT add WC or GL classifications that you are not enrolled for. If you need to add one, you must notify the OCIP Administrator separately and a revised payroll form will be sent to you.

-You MUST include the following:

-Month and year for the report

-Hours worked for each WC and GL class code, even if it is zero

-Payroll for each class code, even if it is zero

-Monthly receipts amount

-Signature and date by an authorized member of your company

-A copy should be kept in your records so your work on this project can be excluded from your own insurance carrier’s audit.

-Payroll reports are forwarded to the New Jersey Compensation Rating & Inspection Bureau and have a direct impact on your experience modifier.

How to Edit Njsda Form 1103 Online for Free

Our PDF editor will make writing files trouble-free. It is very straightforward to update the [FORMNAME] document. Adhere to these actions to be able to achieve this:

Step 1: Press the orange "Get Form Now" button on the following website page.

Step 2: Right now, you can begin editing your New_Jersey. Our multifunctional toolbar is readily available - add, erase, alter, highlight, and conduct similar commands with the text in the form.

The next areas are inside the PDF form you will be completing.

part 1 to filling out 10th

Type in the data in the GL Classification Description, Total, Monthly receipts, GL Code, ManHours, Payroll Receipts Other, DO NOT SEND CERTIFIED PAYROLL, sick vacation holiday pay and, Overtime means those hours in, Total monthly receipts are, The above is a true and complete, Signature, Send this form to, Title, and Date field.

step 2 to entering details in 10th

Step 3: Once you click on the Done button, the ready document is simply exportable to any kind of of your gadgets. Alternatively, it is possible to send it by using email.

Step 4: Just be sure to generate as many copies of your document as possible to prevent future problems.

Watch Njsda Form 1103 Video Instruction

Njsda Form 1103 isn’t the one you’re looking for?

Related Documents

  • Non Profit Lpuna 128

    "... Reg no registration of an unincorporated nonprofit organization pursuant to California corporations code section 2300 Instructions complete and mail the following to the secretary of State document filing support unit 944225 in Sacramento, CA 94244 ..."

  • Forms Chapter 128

    "... Index of exhibits Filing a debt amortization petition under wis stats128 21 in Milwaukee County Petition to Amortize Debts Order appointing Trustee and Enjoining Creditors Notice to Creditors Proof of Claim Completed Plan Order for ..."

  • Nmsu Id

    "... Office of the Registrar New Mexico State University po Box 30001 Msc Ar Las Cruces NM 88003 8001 Telephone 575 646 312 Fax 575 646 1579 NEW MEXICO STATE UNIVERSITY duplicate diploma Order Form Name ..."

  • No Trespassing Letter Form

    "... You are acting as an agent and will go out and get those people removed. The trespass authorization forms can be used on residential or business properties. ..."

Please rate Njsda Form 1103

1 Votes

Related Resources

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .